Much of the cost of providing health care is associated with time spent by medical personnel consulting with patients. Whereas equipment is relatively easy to procure, it is costly to provide the extensive training and experience required by health care professionals to enable them to provide quality health care. The growing demand for medical services at a reasonable cost has placed unprecedented demands on the health-care provider.
An outpatient usually resides at a location away from a health care provider. For example, an outpatient typically resides at home and not in the hospital where his or her doctor may have an office. Thus, the health care provider has far less opportunity to monitor the health status of an outpatient patient on day to day basis. Moreover, an outpatient may be required to see a doctor on a regular basis, often for simple and routine tests. In such a case, the outpatient must travel to the doctor's office or to a hospital, wait to be seen by the relevant health care provider, have the tests performed, and travel home. This inconvenient way of monitoring the health of an outpatient often does not assist the outpatient in the recovery process.
In short, patients in a hospital are regularly monitored. However, outpatients often do not receive this same level of health care.
A system is needed that will help close the gap between the level of care received by hospitalized patients and non-hospitalized patients who must visit the doctor or other health care provider for treatment. It would be advantageous if a health care provider could regularly monitor the health status of patients, including outpatients, without requiring these patients to physically travel to and make an appointment with the health care provider unless it is absolutely necessary to do so.
Many of the advantages of a remote outpatient monitoring system would be negated if the system were exceedingly costly or complex to use. Existing outpatient monitoring systems require the patient to use expensive equipment that is unfamiliar to the patient and complex to use. For example, many existing monitoring systems involve connecting sensors to the patient to monitor vital signs, such as blood pressure or temperature. Other systems require that one or more sensors be physically implanted into the patient's body.
Moreover, these systems often have a dedicated use, for example, they can only be used to monitor one or two conditions of the patient. These systems are less flexible, each being directed towards reporting a fairly narrow range of data to the health care provider, often on an intermittent basis. For example, one system may be capable of transmitting only heart rate and blood pressure; another may monitor and transmit sounds from implanted heart valves; yet another may be needed to monitor and transmit "biologic signals."
For example, U.S. Pat. No. 4,712,562 to Ohayon et al. describes a system to monitor the blood pressure and heart rate of an outpatient that requires the outpatient be provided with a special device that can take blood pressure and heart rate readings, store these readings, and later generate signals for transmission. These signals represent the stored readings and the identity of the patient. In such a system, the outpatient must be supplied with a measurement, storage and signal generating device that is programmed for use by that particular outpatient only.
U.S. Pat. No. 5,172,698 to Stanko describes a dedicated telephonic pacemaker monitoring device that has four electrode touch pads that can detect pacemaker signals or a patient's pulse and transit the detected information over a telephone line.
U.S. Pat. No. 3,882,277 to DePedro et al. describes a portable battery-powered EKG signal detector and transmitter. EKG signals can be transmitted over a telephone link to monitoring equipment at another location.
U.S. Pat. No. 4,068,097 to Verriest describes a system that requires a specially adapted telephone set that is capable of direct communication with a central monitoring station without the handset being lifted.
U.S. Pat. No. 4,337,377 to Van Riper et al. describes an apparatus to monitor biologic signals of a patient from a telephone handset. This system requires the patient to carry a special unit that must be coupled to the telephone handset.
In the above systems, the patient has to obtain and use an electronic device capable of taking readings and transmitting data over a telephone line, often using complex communication protocols. Many of these devices have a dedicated use, i.e., are programmed for use by one patient only or are programmed for use for one set of measurements only.
Thus, there is a need for a system for remotely monitoring the health status of patients that does not require special training or complex equipment that is likely to be expensive. In particular, there is a need for a monitoring system that does not require that the patient be provided with any electronic equipment, thus allowing the patient to use communications equipment that the patient already has in his or her own home.
Further, there is a need for a single system that is capable of being adapted to an individual's evolving physical condition. Each patient may have different conditions that require monitoring. For example, for one patient, pulse information may be important, for another, blood pressure, and for a third patient, temperature. The health care provider needs a single system to easily monitor all conditions of all patients.
Further, as a patient's condition improves, some information may not be needed. Existing systems are not flexible and cannot easily be adapted for each patient's differing and evolving conditions.
Existing monitoring systems concentrate on obtaining information relating to physical conditions, such as blood pressure, pulse, EKG and the like. Often, for example, when a patient is taking medicine or has a psychological problem, the health care provider must additionally monitor other factors, such as how well a patient sleeps, whether the patient feels drowsy or depressed, and whether the patient has an appetite. Existing monitoring systems do not enable health care providers to remotely monitor psychological and other related conditions of a patient.